TLIF
A type of spinal fusion surgery performed between you back and your side
Find out more about TLIF or spinal fusion surgery whereby the incision is made from your side.
TLIF key points
- TLIF or Transforaminal Lumbar Interbody Fusion is a type of spinal fusion surgery.
- To reach your spine the incision is made in the area between the middle of your back and your side.
- TLIF works very well in patients who are suitable. Surgeon experience is important in working out if you are suitable or not. There are multiple complex factors to consider.
- The vast majority of suitable patients that go through modern TLIF surgery are very happy with the result.
TLIF | Spine surgery Brisbane
The surgeon said TLIF. What exactly is that?
TLIF stands for Transforaminal Lumbar Interbody Fusion. It’s a type of spinal fusion surgery whereby the surgeon simply approaches the spine between your back and your side.
Transforaminal Lumbar Interbody Fusion is not even the full name of the surgery. It is actually “transforaminal lumbar interbody fusion, rhizolysis, stereotactic pedicle screw fixation and posterolateral fusion.” Now that is a mouth full!
There is another version where the surgeon literally approaches your spine from the side and it is called OLIF or XLIF (both mean the same thing). Have a read of the spinal fusion section to read more about this.
There are complex factors dictating why a spinal fusion should be performed from the back in one patient, from the side in another and from the front in another. When I see you I will look at all these factors and work out what is best for you, your symptoms and your lifestyle. More importantly, I will work out if spinal fusion is necessary in the first place, and whether there is an alternative and smaller keyhole surgery that will sort out your spine, your pain and your quality of life.
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TLIF surgery success rate Brisbane
Is it successful?
Yes, it is.
In the past surgeries were very big and invasive, with really long recovery times. Luckily, modern technology and techniques have vastly improved this operation, making the surgery smaller, and the recovery more rapid.
These days the single biggest factor determining success is the surgeon’s decision-making skills. TLIF works very well in patients who are suitable. But in patients who are less than suitable, the results are poor.
It is up to the surgeon to work through all the complex factors to work out if you, your symptoms, your scan results and your lifestyle are suitable for this type of surgery. This process is critical.
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When I see you I will take you through this process to work out if this is best for you or whether there is an alternative or smaller keyhole surgery that will sort out your spine, your pain and your quality of life.
The vast majority of patients that go through the modern TLIF operation are very happy with the result. The goal of surgery is to improve your quality of life, whether that is to be pain-free, back on the golf course, or in the gym, or just be able to walk and move around freely.
I will consider all the important factors with you and determine what is best for you and the quality of life that you want to achieve.
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TLIF surgery risks
Is it safe?
Yes, in experienced hands it is safe.
TLIF surgery nowadays is a safe and effective type of spinal fusion surgery, thanks to modern technology and computer-guided systems. Improvement is ongoing as engineers keep pushing the limits of this technology to help further improve this procedure for your benefit.
With all this in mind the risks I will discuss with you are:
- The operation may not work: You may continue to have the symptoms despite the surgery. This is now quite rare.
- The hardware may fail: Despite all the engineering that goes into the spacers and screws, very rarely these screws and spacers may move, break or fail.
- Bleeding: This rarely causes a problem.
- Infection: This is rare in modern surgical practice:
- Antibiotics. When these were invented in the 1940s, surgery was utterly transformed.
- Proper skincare during and after surgery. Healthy skin is a vital barrier to infection: ‘If you look after the skin, the skin will look after you!’
- Shorter surgery. While there is no cut-off point, it is well recognised that the more efficient the surgery, and the less time is taken, the lower the risk.
- General risk of the anaesthetic like clots in the legs, clots in the lungs, urinary tract infections, skin injuries from being on a bed for a long time, and heart or kidney problems. Modern anaesthetic medicine makes many of these risks very low.
I am committed to getting the best possible result for you and minimising the risks. This also includes keeping regular contact with you during the recovery phase.
There are 2 long term side effects I will talk to you about
- Adjacent level disease
- Failure of fusion
The TLIF operation has been performed and perfected over many years. It is also one of the most common low back operations performed around the world today.
This is always an option. I will go through with you what this would look like for your symptoms and quality of life moving forward so you can make an informed decision.
There are 2-3 options available for any one case, differing in the pros and cons. I will present these to you.
Have a read of the spinal fusion segment for a description. I will also describe it in detail for you when I see you.
You will have a general anaesthetic (and be completely knocked out). You will lie on your belly on the operating table, so your back is facing the ceiling. The incision will be made in the lower back on either side of the midline.
In this operation, rather than the spine being approached directly from the back, it is approached slightly more from the side of the spine. It was invented to try to improve operative and recovery times.
One of the first things the surgeon will do is insert the screws into your spine using computer guided navigation. This is a bit like satellite guided GPS that allows the screws to pass safely into the correct portion of the spinal bones. These screws are often between 3-5cm long and between 6-7mm wide. Despite this impressive size, they fit very snugly into the spinal bone and provide great strength for the overall construct. The next step is to approach the disc space from the side. Once this has been found, the contents of the disc are partly removed and into this empty space is placed a permanent spacer. Then the screws are all connected to rods and everything locked into place.
The posterior approach means going through muscle in your back, and this is what causes most of the pain. With adequate pain relief you will be reasonably comfortable.
The scar in this part of the back actually heals up quite nicely. It will never disappear but often it is hard to see after a few months.
Often yes, and I arrange to see you in a week after surgery to remove these.
TLIF recovery time
What can and can't I do afterwards?
On average you will be in the hospital for 1 to 4 days. Your hospital stay after TLIF surgery depends on who fits you normally and how many parts of your spine are fused.
Surgery is just one step. To really get the best results you need to commit to a full recovery period. And this doesn’t mean “just resting”. As a matter of fact, I will encourage you to be as active as you can. Getting your confidence back early on is really important. You will be surprised how much you are allowed to do straight after TLIF surgery.
As I often say, recovery is like compound interest; if you do the time, you’ll get the best result. If you shortchange yourself and bail out early you will miss out on significant benefits long term.
I recommend a minimum of 2 weeks off work to get your confidence back and feel comfortable.
Physiotherapy has a very important role postoperatively. It helps reduce the muscle soreness and stiffness from the surgery.
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What else do I need to know?
If you would like me to assess your condition please contact my team to book an appointment.
Ready to make an appointment?
Alex consults from the private Neurosurgery clinic at Greenslopes Private Hospital.
Lobby Level
Greenslopes Private Hospital
Newdegate St
Greenslopes QLD 4120
